• 대한치과마취과학회지
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• 제4권1호
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• pp.25-29
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• 2004

Anaphylactic reactions to anesthetic drugs could potentially produce life-threatening immune-mediated crisis. Most published reports are associated with neuromuscular blockers and anaphylactic reactions to inhalation anesthetics are rare. A 25-year-old male patient with no significant medical history and no previous abnormal drug reaction was scheduled for orthognathic surgery under general anesthesia. After uneventful anesthetic induction and nasotracheal intubation, generalized urticaria and erythema were detected during the maintenance period with $O_2-N_2O$-enflurane. No severe changes of vital signs and no ventilation problem were accompanied. The operation was cancelled and the cutaneous lesions were faded away during the recovery with 100% $O_2$. The skin-prick and intradermal tests showed that he was hypersensitive to all halogenated inhalation anesthetics including enflurane and not to intravenous anesthetics and neuromuscular blockers. The re-operation was safely carried out under intravenous anesthesia with propofol-fentanyl-vecuronium. We report this case of intraoperative anaphylactic reaction to enflurane with literature review.

• KIEAE Journal
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• 제13권3호
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• pp.111-120
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• 2013

The purposes of this study were to investigate the actual state of the indoor thermal and air environment in general apartment houses during winter in Cheongju City, to analyze the related factors with the indoor thermal and air environment, and to make suggestions for the improvement. A series of visiting field investigation was conducted in twenty units between 28th December, 2010, and 11th March, 2011. The field investigations included the measurement of physical indoor environmental conditions, the observation of architectural characteristics and resident's behavior, and the on-site questionnaire survey of residents. The measured values of each units were compared to evaluation standard and were categorized to group by the difference between units. Factors related to the difference of the measured values between the groups were analyzed. The findings are summarized as followed. The indoor temperature of apartment houses during winter in Cheongju City was generally suitable. The relative humidity was slightly dry, while the $CO_2$ concentration was found to be excessively high. The factors related indoor environment were analysed as heating operation, ventilation, gas range use, and hanging out the wash to dry in indoors.

• Tuberculosis and Respiratory Diseases
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• 제62권5호
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• pp.398-405
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• 2007

연구배경: 내과계중환자실에서 72시간 이상 장기간 기계 환기를 받은 환자들의 자료가 부족하여 기저질환별, 기계 환기가 필요했던 원인질환별로 장기 예후를 관찰하며, 또한 1년째에는 삶의 질 평가를 같이 수행하여 이 환자들의 삶의 질 상태를 평가 하고자 하였다. 방 법: 2003년 3월부터 2003년 7월까지 서울아산병원 내과계중환자실에서 72시간 이상 기계 환기치료를 받은 환자 73명을 대상으로 1, 3, 6, 12, 24, 36개월 생존율을 전향적으로 관찰하고 1년 생존자를 대상으로 Short Form 36(SF-36)을 이용하여 삶의 질을 측정하였다. 결 과: 대상 환자들의 1개월 생존율은 54.8%(40/73), 3개월 생존율은 39.7%(29/73), 6개월 생존율은 30.1%(22/73), 12개월 생존율은 20.5%(15/73), 24개월 생존율은 18.3%(13/71), 그리고 36개월 생존율은 16.9%(12/71)이었다. 3년간 생존율은 기계 환기가 필요했던 원인질환별로는 차이가 없었고, 기저질환별로는 신생물 또는 만성간질환이 만성폐질환이나 만성신장질환에 비해 예후가 불량하였다(p<0.05). SF-36을 이용한 삶의 질 평가에서 정상 대조군과 비교 시 정신적 건강영역에서 Role limiting due to emotional problem을 제외하고 모두 낮은 값을 보였다. 결 론: 한 대학병원 내과계중환자실에서 72시간이상 장기간 기계 환기를 받은 환자들의 3년간 생존율은 낮았으며, 12개월까지 지속적으로 낮아지나 12개월부터 36개월까지는 유지되었다. 1년 시점에서 삶의 질 평가 시 이 환자들의 삶의 질 상태가 낮음을 보여주었다.

• 대한치과마취과학회지
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• 제3권2호
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• pp.98-102
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• 2003

Patients in end-stage renal disease (ESRD) and chronic renal failure present a number of challenges to the anesthesiologist. They may be chronically iii and debilitated and have the potential for multiorgan dysfunction. A 65-year-old male patient with ESRD was scheduled for oral cancer surgery under general anesthesia. He was in regular hemodialysis three times a week and secondary hypertension with left ventricular hypertrophy was accompanied. He also had chronic metabolic acidosis and hyperkalemia. The day after hemodialysis, general anesthesia was carried out. Uneventful anesthetic induction using thiopental and vecuronium and nasotracheal intubation were carried out. General anesthesia was maintained with isoflurane for 9 hours. During the anesthesia, he did not have any problem but persistently increasing serum potassium level. After anesthetic emergence, he was transferred to intensive care unit for mechanical ventilation. So we report this successful case of anesthetic management in a patient with ESRD for oral cancer surgery, which massive bleeding and long anesthetic time were inevitable in, from the preoperative preparation to anesthetic emergence.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제26권1호
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• pp.73-84
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• 2020

Purpose: Though Korean healthcare services have been upgraded, infection and fire had been broken out in general hospitals. And higher concerns about quality assessment made it to clinical laboratory design guideline studies. So, this study investigates the facilities, equipment and personnel of laboratory medicine focusing on more than five hundred fifty bed hospital, and contributes to make guidelines for safety and efficiency in lab. Methods: Questionnaires to supervisor technologist and field surveys to medical laboratories in korean hospitals have been conducted for the data collection. 16 answers have been analysed statistically by MS Excel program. Results: Most of the sample tests such as hematology, clinical chemistry, immunology, transfusion, urinalysis, microbiology and molecular diagnosis are performed by more than 80% in large sized general hospital laboratory. In the test methods, automatic analyzers are used up to 80%, total laboratory automation up to 43% in clinical chemistry and immunology, and manual tests in all sorts of the test. There are placed in single lab or two and three labs above the ground, which are all in semi-open lab. There is some correlation with the number of specimens and the number of lab people depending on the number of hospital beds. Laboratory environment shows that work distance is good, but evacuation path width, visibility, separation of staff area from automatic analyzer, and equipment installations are needed to have more spaces and gears. Most of the infection controls are equipped with mechanical ventilation, air-conditioning, washbasin and wastewater separation, BSC installation and negative pressure lab room. Implications: Although the laboratory space area is calculated considering the number of hospital beds, type of tests and number of staff, hospital's expertise and the samples numbers per year should be taken into account in the planning of the hospital.

• 핵의학기술
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• 제16권2호
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• pp.18-24
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• 2012

Lung SPECT는 planar scan 보다 깊이 위치한 병변을 명확히 보여주며 보다 예민한 것으로 보고되고 있다. 그러나 ventilation SPECT는 정맥주사를 통해 방사성의약품을 주입하는 perfusion SPECT와 다르게 환자의 호흡을 통해 흡입시키므로, 원활한 호흡이 불가능한 환자의 경우 목적 장기에 방사성의약품의 섭취율이 저하되고 검사에 유효한 적정count/rate가 낮아지므로 필연적으로 검사시간이 길어지게 되어 이에 수반되는 여러 문제로 인하여 실제 임상에 적용하기 어려운 실정이다. 따라서 본 연구는 고감도(high sensitivity) 특성을 지닌 AP (All Purpose) 혹은 GP (General Purpose) collimator를 사용하여 low count/rate 환자의 검사시간을 단축시킴으로써 lung ventilation SPECT 임상적용 가능성과 유용성을 평가하였다. 정상 성인 남녀 4명($24.3{\pm}0.95$세)을 실험대상으로 Technegas 370 MBq을 흡입시키고, E.cam SPECT를 사용하여 count/rate를 측정한 후, LEUHR, LEHR, LEAP collimator를 장착하여 300counts acquisition 조건으로 ANT, POST, LPO, RPO, both-LAT 총 6 view의 lung ventilation planar scan 하였다. 동일 실험 대상자를 본원에서 사용하던 기존 프로토콜을 적용하여 70 kcounts/view acquisition 조건으로 high counting mode SPECT를 시행하고, 같은 방법으로 7kcounts/view acquisition하여 비교 실험인 low counting mode SPECT를 시행한 후 모든 실험의 결과를 lung segmentation ratio와 검사 소요시간을 통해 비교하여 분석하였다. 각 실험군 사이의 상관관계를 분석하기 위해 paired t-test를 시행하였고, p값이 0.05를 초과할 때 실험의 통계적 의미가 있는 것으로 판단하였다. 모든 자료의 통계처리는 SPSS ver. 20을 사용하였으며, 각 실험 결과는 산술 및 기하 평균(mean)을 구하고${\pm}$표준편차(SD)를 산출하였다. 실험 결과 lung planar scan은 300 kcounts/6 iew를 acquisition하여 총 1,800 kcounts를 획득하였다. 반면 7 kcounts/view로 acquisition한 low counting mode SPECT의 경우 collimator 종류에 따라서 최소 773 kcounts에서 최대 1,106 kcounts를 획득하였고, 70 kcounts/view로 acquisition한 high counting mode SPECT의 경우 collimator 종류에 따라서 최소 7,984 kcounts에서 최대 10,222kcounts를 획득하였다. 모든 실험 자료를 통해 실험대상 4명의 lung segmentation ratio를 산출하고, 평균값과 표준편차를 계산한 결과, LT:RT lung ratio는 순서대로 각각 45.5:54.5 (${\pm}0.26$), 45.4:54.6 (${\pm}0.40$), 50.1:49.9 (${\pm}0.28$), 49.4:50.6 (${\pm}0.57$)이었다. 따라서 정량분석한 결과 planar scan과 low, high counting mode SPECT사이 collimator 종류에 의한 lung segmentation ratio는 오차 범위내에 모두 존재하였다. 보다 자세한 분석을 위해 기존의 LEHR collimator를 장착한 planar scan과 비교 실험인 LEAP collimator를 장착한 low counts mode SPECT를 통계처리한 결과 p-value가 0.10이상으로 두 실험의 결과는 통계적으로 유의하였다. 실험에 소요된 시간을 분석한 결과 planar scan은 LEUHR, LEHR, LEAP collimator 순서로 각각 $1803{\pm}268$ sec, $915{\pm}162$ sec, $501{\pm}134$ sec이었고, 비교실험인 low counting mode SPECT는 $1125.5{\pm}103.6$ sec, $900{\pm}64$ sec, $740{\pm}0$ sec 이었으며, 본원에서 사용하던 기존 프로토콜인 high counting mode SPECT는 $5794.5{\pm}946.5$ sec, $3620{\pm}397.9$ sec, $2020{\pm}104.5$ sec이었다. 관심실험인 LEAP collimator를 장착한low counting mode SPECT의 검사 소요시간 740 sec에 비하여, 기존 본원의 프로토콜인 LEHR collimator를 장착한 high counting mode SPECT의 검사 소요시간 평균은 3620sec이므로, 약 5배 정도 시간 단축이 가능한 것으로 조사되었으며, 모든 실험의 정량분석 결과도 임상적으로 유의한 것으로 분석되었다. 결국 high sensitivity LEAP collimator를 장착하여 lung SPECT를 시행하면, 임상적으로 유의한 정량분석 결과를 얻을 수 있으며, 동시에 검사시간을 효과적으로 단축시킬 수 있음을 의미한다.

• Environmental Analysis Health and Toxicology
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• 제24권3호
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• pp.203-211
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• 2009

A lesser degree of research is available with respect to indoor radon characteristics associated with occupants' exposure. The present study evaluated the radon levels in several public-access buildings or underground facilities, and their temporal variation in underground facilities. Radon measurements were conducted in 2005 and 2006, utilizing a continuous radon detector. A solid alpha detector (RAD7) was utilized to measure indoor radon levels. The mean radon concentrations obtained from the building or facilities were in a descending order: platforms of Daegu subway line 2, 2005 (32 $Bq/m^3$), hot-air bathroom (14 $Bq/m^3$), basement of office building (14 $Bq/m^3$), underground parking garage (14 $Bq/m^3$), underground shop (12 $Bq/m^3$), nursery (10 $Bq/m^3$), platforms of Daegu subway line 2, 2006 (9.0 $Bq/m^3$), platforms of Daegu subway line 1, 2006 (8.9 $Bq/m^3$), supermarket (7.9 $Bq/m^3$), hospital (7.3 $Bq/m^3$), and second-floor of office building (5.7 $Bq/m^3$). In general, underground-level facilities exhibited higher radon levels as compared with ground-level facilities. It was suggested that ventilation is an important parameter regarding the indoor levels of a subway. There was a decreasing or increasing trend in hourly-radon levels in a subway, whereas no trend were observed in a basement of office building. In addition, the radon levels in the subway lines 1 and 2 varied according to the platforms. The radon levels in the present study were much lower than those of previous studies. The average annual effective dose (AED) of radiation from indoor radon exposure was estimated to be between 0.043 and 0.242 mSv/yr, depending on facility types. These AEDs were substantially lower than the worldwide average AED (2.4 mSv/yr).

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.105-110
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• 1988

흡입전신마취시에 마취호흡기를 사용할 겨우 환자에게 가장 적절한 1회 호흡량을 흡입시킬수 있는 방법을 알아보기 위하여 전신마취환자 30명에서 흡입기압력 $10cmH_2O$가 되도록 용량조절마취호흡기의 1회 호흡량을 조절하고 호흡수를 분당 12회로 하여 기계조절양압호흡을 유지시켜 보았던 바 다음과 같은 결과를 얻었다. 1) PH : $7.39{\pm}0.01$로서 정상범위내 이었다. 2) $PaCO_2$ : $34{\pm}0.6mmHg$ 로서 약간의 과환기상태 이었다. 3) $PaO_2$ : $228.0{\pm}8.2mmHg$ 이었다. 4) Buffer base : $20.7{\pm}0.3mEq/{\ell}$로서 약간의 염기부족상태 이었다. 이상의 결과로 미루어 보아 전신마취시 충분한 근 이완상태에서 기계조절호흡을 시행하는 경우 1회 호흡량 조절은 흡기압력을 $10cmH_2O$로 유지함이 가장 바람직한 것으로 사료된다.

• International Journal of Air-Conditioning and Refrigeration
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• 제15권3호
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• pp.101-107
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• 2007

Indoor air quality becomes of a concern recently in view of human health. This study investigates the air diffusion performance and the air change efficiency of a classroom, when outdoor air is introduced in two different ways in addition to the heating/cooling operation of a ceiling-mounted heat pump. A CFD analysis has been performed to investigate the effect of the discharge angle of the air jets from the heat pump for both parallel and series types of outdoor air system. It is observed that the series type creates more uniform indoor environment compared to the parallel type in general. It can be concluded the discharge angle should not be larger than 40o for the parallel type, in order not to generate thermal stratification in the room.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권4호
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• pp.313-316
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• 2016

Airway obstruction in pediatric patients always poses a challenge for anesthesiologists. Beckwith-Wiedemann syndrome causes various abnormalities such as macroglossia and omphalocele. Patients with these abnormalities often need corrective surgeries. Management of difficult airway caused by conditions such as macroglossia in patients with this syndrome could be challenging. We encountered a case of difficult airway in an infant with Beckwith-Wiedemann syndrome. It was predicted that macroglossia might cause difficult ventilation, intubation, and extubation. Preoperative assessment and preparations for difficult airway should be considered.